Joined another club

   Without using a stainless steel cannula it was presumed inevitable.  No time was wasted in getting to it.

   We've been chasing highs for the last 36 hours (high teens - low 20s, 320-414).  Yesterday Jonathan seemed to have a slight fever (warmer than usual forehead) at lunch but was otherwise himself and wanted to stay at school, but when he got home his temperature was normal, as well as this morning.  The working theory yesterday was a bug.  Bobbie is still fighting something off and I just got rid of a sore throat and cough myself.

   This morning I got a call from Latchkey - BG: 28 (504).  He was completely non-symptomatic and very much himself.  I had them bolus and still give him his snack and headed over to get him.

   His next set change was supposed to be tomorrow evening.  Since there was no fever today and his numbers were still high we decided it could be a site issue.... Sure enough...

   A new set is in and he's going to test hourly for the rest of the day.  The remarkable thing is he was almost completely asymptomatic.  I now have another mindset change from MDI and another lesson learned.

Upgrade!

   Oh!  And speaking of cool......


    The watch kinda took a backseat today, at least in the "new" and "cool" arena.  I know I kinda left that little cliffhanger at the end of the previous post...  I did that on purpose, because I knew something.  I pretty much knew it when we started Jonathan on the pump but it wasn't a sure thing until the middle of last week, and even then we didn't have it in out hot little hands.


   Well, now it's here.  Fresh through the Health Canada approval process and a brief stint with the Assisted Devices Program, Jonathan is one of the first people to get Medtronic's Veo.  Built upon the same platform as the Paradigm, it does all that his current pump can... and more.

   Where to start...  There are many subtle differences, like bolus in 0.025u increments up to 1, then 0.05 after that instead of 0.1 and basil in 0.025u/hr instead of 0.05.  Reworked set change menu for less button pushing.  On-board event capture to record BG, insulin, meal, exercise and other as opposed to getting into CareLink to enter it into the log book.  IOB is now on the status screen.  And there's probably a few other little goodies in there I have yet to come across.

   One of the things that helped us pick Jonathan's Weapon of Choice was the built in CGM system.  Despite the sensors being financially prohibitive for us to use them all the time, we can and likely will used them from time to time for any number of reasons...  Here's the biggie and the top new thing for Veo - Low Glucose Suspend (LGS).  It does what it says... When BGs meet specified criteria, insulin delivery will be automatically suspended for a period of time.

   We knew Medtronic's Pathway Program was there to move him up as new technology becomes available, and because we are within our 90-day trial period, we get a full ride to new.  Even if something bigger and better comes along in the next 5 years we can still choose to upgrade with a cost dependent on where we are in the cycle.

   There are two main things I want for Jonathan when it comes to Diabetes: 1) First and foremost, a cure.  2) Until a cure, the best possible management of his diabetes.  LGS is a step, and one side of a coin in an artificial pancreas.  The dicier side is the high glucose correction / automatic bolus.  Those two things, coupled with a dual hormone delivery system (glucagon) are the basis of a self contained support system and along with the integrated cannula / sensor would be no more intrusive than the current infusion set.

   My patience is really a hypocrisy.  As much as I want to get better and better management tools, I really want a cure.  I want a cure for Jonathan, I want a cure for all the kids that have recently been diagnosed, I want a cure for everyone with some years under their belt.  I want a cure for all the people that have been waiting decades.  I want a cure for the ones that are going to be diagnosed.  I want the CDEs, and the pharma reps, and everyone making a living off of diabetes to find their living somewhere else... and I want it NOW!!  But in the mean time, I want a safe and happy and healthy Jonathan who can grow and learn and reach his potential, and then go beyond it.

   To that end, next week, after the nurses at the clinic are trained on the Veo, Jonathan will have the latest and greatest available to him.  :)

Watch me!

   I'll spare you another round of "how much we love the pump".  Believe it or not, we did find one shortcoming that we are not crazy about right from the beginning.  It's nothing huge, but it was concern enough that I decided to add to Jonathan's gear.

   When we bolus Jonathan and have the BG reminder on, we can set the pump to alert when a certain period of time has elapsed.  While this is a neat feature, it has two issues that we don't like: 1) Inside his neoprene case the "discrete" alarm is not loud enough to be heard reliably, especially in a busy setting, like a classroom or a playground.  2) The alarm automatically unlocks the keypad, and you can't change that.

   For the past few weeks, we've been relying on the teachers and Latchkey staff to remember when to test him, and they've done.....

    *** This just in... mystery solved.  We've been randomly missing data in Jonathan's downloads... they're been randomly using his the meter I put in his lunch bag as a back-up... his old Accu-Check... the one that doesn't talk to the pump." ***

                                .......  a great job (aside from using the WRONG METER).  And that little tidbit did come to light in the middle of my statement of praise.  On the bright side, they are testing, regularly, and recording.  And poo-poo on Medtronic for not allowing manual inputs of BG on the CareLink site - not thought through too well if I do say so myself.

   OK, back to our dilemma of inaudible audibles and auto-unlocks....  I thought to myself, Jonathan has taken such good care of his Medic-Alert bracelet over the past year, I think he could be responsible for a small wrist watch.  So one day while I was on "vacation" a couple weeks back for pump start I started looking around.  I stopped at the closest Wal-Mart and started looking at watches.  They had all kinds of cool little kids watches, most digital, some with an alarm (1 alarm).  I asked the lady at the jewelry counter if they had kids watches with more than one alarm.  She looked at me like I was asking for a $20 genuine Rolex.

   As with many good things, I decided to hop right to the internet.  I was amazed and the variety of "medical watches" available.  There were even ones geared specifically towards kids.  There were some amazingly beautiful ones that you might have expected to find in the collections of James Bond, Bruce Wayne, or Tony Stark.  And, as you may have guessed, the majority of them were grossly overpriced, at least for my taste...err.... budget - my tastes exceed my budget, but I'm cheap so it all works out.  It took a couple of hours, but I found a great deal on one of the watches I though could be the ticket.  I saw it as high as $75-80.  But I found it for $32.07US + $4 shipping to Canada.

   From what I can gather it was originally intended for children with "potty issues", but with 8 alarms per 24hr period...  guess what....  it's the new string-tied-on-a-finger.  This weekend we'll be "training" Jonathan to respond to the alarms with a BG test.  The alarms I've already programmed in are about 2 hours after his school-day breakfasts and lunches.

   Funny, I started this blog post with a peeve in my head about people doing "something" wrong and the BG not getting to the meter, and ended up with a new working theory.... A neato watch that Jonathan will hear and no meters that don't link to the pump should help ensure we get all our data!

   Anyway, the watch is a great concept (I think).  We just got it and he starts wearing it tomorrow so I can't attest to it's greatness yet, but I think the concept was definitely my cool idea of the month.

Oh!  And speaking of cool......